Once at the clinic, I handed her OHIP card to the lady at the front desk, she swiped her card, and told me, "Little Bear has no OHIP coverage. It has been cancelled."
I know what you're thinking. What? Cancelled? Can that really happen? I know because I was thinking the same thing. "What? Cancelled? Can that really happen?" I said to the lady. "Yes. It can. You'll have to call the OHIP office on Monday. In the meantime, if you would still like to see the doctor, that will be $75." So I handed her my MasterCard, which felt entirely un-Canadian. Paying for a doctor's visit? What's next, declaring a nation-wide ban on Tim Bits? Will people stop saying sorry for things they need not be sorry about, but can't help it because they're all just so darn polite? That's a Canada I just don't want to live in.
Anyway, we saw the doctor and yes, Little Bear had an ear infection. We picked up her amoxicillin and headed home to wait in wonderment until Monday arrived and we could call the OHIP office and put an end to this OHIP mystery.
First thing Monday morning my husband called the OHIP office. This is what they told him. Get ready, it's a good one...
"Oh, yes, well, we sent Little Bear a survey in the mail and it was returned, marked undeliverable. We here at the OHIP office figured that meant your 5-year-old moved and didn't bother to call us with her new address. So, we cancelled her OHIP coverage knowing that the next time she was at a walk-in clinic or a hospital emergency room, and tried to use her OHIP card, she would realize the coverage was cancelled. Then, on Monday, when she called us to find out why, we could update her new address." OK. I'm paraphrasing a bit, but that was the gist of what was said. They cancelled her OHIP to force her to call and update her address. But the funny thing is, we didn't move, and no, she didn't either. Because she's 5. She's 5 and, call her crazy, still lives at home. And even if at the ripe old age of 5 she did decide to move out and rent a condo downtown, she wouldn't know how to call the OHIP office to update her address. She only recently figured out how to zip up her coat.
I don't actually know why the address is so important. So what if she moved downtown, the important thing is that she lives in Ontario, right? That's what the O in OHIP stands for. I could see if she wanted to go to an out-of-province kindergarten, and packed up her things and moved to Alberta. But then, flying to Ontario with an ear infection would seem like a long way to go for amoxicillin, don't you think? I guess maybe she could have flown home for a visit, and caught the ear infection from someone on the plane (can you catch an ear infection?) and when she got here she decided to use her OHIP card to visit the walk-in clinic for free, which she really shouldn't have done, since she now lives in Alberta. In that case, maybe it does make sense that OHIP cancelled her coverage. Hmm. I guess I owe you an apology, OHIP office. I'm sorry for getting so angry. Let's get a 10-pack of Tim Bits and call a truce.
I used to work at the ministry of health and the ministry cancels cards all the time. The most common reason is because someone didn't respond to a letter in the mail or it bounced back undeliverable. This is a fraud prevention measure. If someone has moved it is possible that they are no longer in the province and therefore no longer eligible for coverage. There used to be tens of thousands of people living outside of Ontario (usually in the states) and still making use of OHIP for hospital care, etc. This tool has helped reduce those numbers significantly. So while it sucks when it happens to you, it is relatively easy to resolve if you are in fact resident in Ontario. That said, most clinics and hospitals will run you a tab and expect you to pay if you don't resolve it within a set period of time. Once reinstated the clinic should either refund you in exchange for the current renewed OHIP card number or you should submit a claim for reimbursement from the ministry.
ReplyDeleteI know the policy makes sense, but it was frustrating nonetheless! And, no refund for us. :(
DeleteWow, what an experience! It's amazing how often the left hand doesn't know what the right hand is doing in the insurance world. It reminds me of a time my birth date was put on a form wrong, and a health visitor came insisting they needed to see the newborn baby in our home. Apparently they thought I was born in 2014!
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